超重或肥胖人群动脉僵硬度与心血管疾病危险因素的相关性研究

Correlation of arterial stiffness with risk factors of cardiovascular disease in overweight/obese population

目的评估上海市浦东新区陆家嘴社区超重或肥胖人群动脉僵硬度与心血管疾病危险因素之间的关系。方法本研究于2009年7月至8月底选取自然人群2095例;通过体重指数（Body Mass Index,BMI）评价超重或肥胖,将其中达到超重或肥胖诊断标准的939例作为研究对象;以踝臂脉搏波传导速度（ankle-brachial pulse wave velocity,baPWV）评价动脉僵硬度;以Pearson相关系数评估与baPWV呈线性相关关系的心血管危险因素;以二分类logistic回归分析评估动脉僵硬度的独立危险因素。结果 （1）高动脉僵硬度组与动脉僵硬度正常组在年龄、性别构成、腹围、收缩压、舒张压等变量间均存在差异。（2）与baPWV呈线性相关关系的变量有：年龄（r=0.546,P=0.000）、腹围（r=0.148,P=0.000）、收缩压（r=0.520,P=0.000）、舒张压（r=0.275,P=0.000）、总胆固醇（r=0.126,P=0.000）、空腹血糖（r=0.218,P=0.000）、糖化血红蛋白（r=0.172,P=0.000）等。（3）在调整性别、BMI、糖尿病史、血脂异常史、肾功能后,与baPWV呈独立相关的变量是高血压史（OR=3.996,P=0.000,95%CI：2.821~5.661）、甘油三酯（OR=1.428,P=0.000,95%CI：1.201~1.698）、年龄（老年与非老年）（OR=5.35,P=0.000,95%CI：3.728~7.676）。结论年龄、高血压史、三酰甘油是超重或肥胖人群动脉僵硬度增加的独立危险因素;baPWV的升高可在一定程度上预测心血管疾病的发病风险。

Objective To evaluate the relationship between arterial stiffness and risk factors of cardiovascular disease（CVD） in a community based middle-aged overweight/obese population.Methods The study was carried out in 939 middle-aged overweight/obese subjects selected according to body mass index（BMI） from Shanghai Lujiazui community during July and August 2009.The anklebrachial pulse wave velocity（baPWV） was used to evaluate arterial stiffness; the correlation between CVD risk factors and baPWV was assessed by Pearson correlation coefficient; the binary logistic regression analysis was used to assess the independent risk factors of arterial stiffness.Results There were significant differences in age,gender,waist circumference,systolic blood pressure,diastolic blood pressure and other variables between high arterial stiffness group and normal arterial stiffness group.The baPWV was correlated with age（r = 0.546,P = 0.000）,waist circumference（r = 0.148,P = 0.000）,systolic blood pressure（r = 0.520,P = 0.000）,diastolic blood pressure（r = 0.275,P =0.000）,total cholesterol（TC）（r = 0.126,P = 0.000）,fasting glucose（r = 0.218,P = 0.000） and glycosylated hemoglobin（r = 0.172,P = 0.000）.After sex,BMI,history of diabetes,history of dyslipidemia and renal function were adjusted the variables independently associated with baPWV were history of hypertension（OR = 3.996,P = 0.000,95% CI：2.821 ~ 5.661）,triglycerides（TG）（OR =1.428,P = 0.000,95% CI：1.201 ~ 1.698） and age（OR = 5.35,P = 0.000,95% CI：3.728 ~7.676）.Conclusion Age,history of hypertension and triglcerides are the independent risk factors of increased arterial stiffness in overweight/obese population and the elevated baPWV can predict the risk of cardiovascular disease to some extent.